degeneration of the MSK system with age Flashcards
(12 cards)
ageing
- affects the balance of mechanisms which ensures homeostasis within organs
- alters tissue response to injury
- associated with accumulation of genetic damage
- elicits antagonistic/compensatory mechanisms- initially beneficial but chronicity leads to further damage- results in phenotype alterations
- may overlap with pathological syndromes
generic processes with ageing
- decreasing amount of tissue
- altered molecular disposition of matrix
- accumulation of degraded molecules
- reduced efficiency of functional tissue elements
- reduced synthetic capacity of differentiated cells
- altered levels of trophic hormones, growth factors/cytokines
consequences of MSK ageing
Altered gait and balance leading to falls and fear of falls
Increased risk of injury, particularly fracture
Chronic pain in 50% of community dwelling elderly and 80% of those in care
Social isolation if living independently
Loss of independence and admission to care home
osteoarthritis
A disorder of synovial joints which occurs when damage triggers repair processes leading to structural changes withina joint
The most common joint disease world wide affecting 18% of women and 10% of men over the age of 60yrs
A complex and multifactorial condition involving genetic, biological and biomechanical factors which affect risk
Concept of simple “wear and tear” damage now outmoded
Knee > hip > hands and wrists > ankle and foot
osteoarthiritis - pathogenesis
draw out
treatment of osteoarthiritis
- therapeutic exercise and weight management
- topical NSAIDs for knee
- oral NSAIDs considered but long term risk taken to account
- paracetamol/weak opioids for short term pain relief
- intra-articular steriods (short term)
- consider joint replacement
osteoporosis
A progressive bone disease characterised by low bone mass and microarchitectural deterioration of bone tissue which leads to an increased risk of fragility fractures
boen remodelling
Activation: preosteoclasts are stimulated and differentiate under the influence of cytokines and growth factors into mature active osteoclasts
Resorption: osteoclasts digest mineral matrix (old bone)
Reversal: end of resorption
Formation: osteoblasts synthesize new bone matrix
Quiescence: osteoblasts become resting bone lining cells on the newly formed bone surface
risk factors of osteoporosis
non- modifiable: previous fracture, parental history, early menopause, age, female gender
modifiable- low BMI, smoking, alcohol intake
coexisting disease- diabetes, RA/SLE, IBS, chronic liver disease, asthma, HIV
drug therapy- long term antidepressants, PPIs
treatment of osteoporosis
- antiresorptive (reduces bone turnover): bisphosphonates, denosumab, romosoumab
anabolic (stimulates bone formation)- romosozumab, teriparatide
sacropenia
- progressive/generalised skeletal muscle disorder. associated with increased likelihood of adverse outcomes including falls, fractures, physical disability/mortality
treatment of sarcopenia
- resistance of aerobic exercise
- increased protein intake
